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Thyroid UK
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adrenal cortex or adrenal extract?

Sorry if this has been asked before.

I read recently that patients with more severe adrenal fatigue can feel better on adrenal extract, while patients with mild or moderate AF should try adrenal cortex (ACE) first. It seems products with adrenal extracts contain more ingredients, and possibly more helpful ones, than ACE products.

I have avoided adrenal extracts, after reading that they can cause all sorts of nasty side effects, like adrenaline surges, and put even more unwanted stress on your exhausted adrenal glands.

Does anyone know if there is any truth to the statement that adrenal extracts can be better for people with more pronounced adrenal fatigue?

I just got the results back from a hair mineral analysis, and one of the findings is that I have low cortisol levels. I have been on Medrol (6 and 4 mg alternatively) for a few years now, for adrenal fatigue, but I realise it has either not been effective for me, or at least not effective enough. So now, I am looking for a natural treatment (I'd prefer to avoid prescription hydrocortisone if at all possible). There are literally hundreds of supplements out there, so I feel quite overwhelmed when trying to separate the good ones from the bad ones...

My doctor (a Hertoghe doctor) preferred Medrol for the beginning because I tended to retain fluid, which to me is quite normal, since I was also seriously hypothyroid back then, despite high doses of levothyroxine. My doctor has also told me that Medrol won't show up on labs, so there would be no use measuring my cortisol levels while on it. The only way to tell if it's working or not is to go by symptoms...and I 'm honestly not sure I'm that impressed with the results so far. Maybe I'd need to go higher than 4 mg daily (I think 4 mg = 20 mg of HC is the lowest physiological dose recommended for adrenal fatigue)?

Has anyone successfully treated adrenal fatigue with supplements and, if so, which one(s)?

16 Replies

When I was much worse, I used whole adrenal plus extra stuff like Rhodiola, but now I am much better I find cortex works better for me. But that's just me.


That seems to corroborate the statement that cortex could be too weak to begin with, but could work once your adrenal glands are stronger...which to me indicates that whole glandular is somehow stronger. It's often stressed that whole glandular (unlike cortex) contains adrenaline, and that people sensitive to adrenaline should avoid it...but I have never read that whole adrenal are actually stronger than cortex. If that is indeed the case, I think I may have made a mistake starting on cortex only, only to avoid extra adrenaline...I am not even sure I have excess adrenaline...

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Hi, Angel of the North

I'm asking lots of people lots of questions at the mo about cortex only. I am curious when you say you were much better, did you take tests of some kind or was it how you felt? The reason I ask is that I am taking NAX but my adrenal saliva was high, not suppressed, so I am thinking I should switch to cortex only, to avoid the adrenaline. Thanks, Sue :-)


Just how I feel. I haven't done another saliva test. but I am less tired and I rarely get dizzy on standing, and it's been a couple of years since I last had to lie on the ground for a few hours because I couldn't get up. My last saliva test showed the right pattern through the day, but right at the bottom of the range.


Hiya, thanks for replying .

So your postural hypotension is sorted? I have that too. Do you think your recovery was down to the whole adrenal supplement or other things you did? ( I am taking NAX which has the supporting vitamins and minerals too) I'm curious why you switched because I think that based on my saliva results, my adrenals are not soooo bad although my ankle reflex and postural hypotension point to it. Also, my daughter doesn't have the ankle reflex problem and only minor postural hypotension but she has experienced issues such as yours i.e needing to lie down during the day, unable to wake up, unable to sleep, anxiety, depression etc and the beginnings of hashimotos. I am trying to get an angle on all of this because I think my daughter needs adrenal support too although her BP and reflexes aren't too bad her saliva test was very similar to mine. What a nightmare it all is :-(

Thanks, Sue .


When I first started supplementing, I was taking nutri meds whole adrenal and I only needed one. I switched Nutri adrenal as they were much cheaper but needed 4 to get the same effect. I wanted to switch back but could only get cortex and found I did better - just luck really.

I still occasionally get the postural hypotension, but not often - a couple of times a month maybe.

Not to depress you , but I have been getting over this now since 1990 - so change of diet, change of job, supplements and meditation have all played a part. I think meditation (and healing sounds music) have had more effect than any other single thing.


Brill, thanks very much. Good ole meditation, sorts most things out :-)


Hi Anna

Iv been taking the Nutri Adrenal extra for 3 years now, under guidance of Dr Peatfield, I was diagnosed with Adrenal

Fatigue brought on by Thyrotoxicity. I started at 1, went to 6 when I was really bad, now I'm on 3 alongside T3. I have also started taking dessicated Thyroid in the afternoon, which is helping my energy levels. The Nutri adrenal contains B5 for cortisol regulation, Adrenal Gland and Pituitary. It's not for everyone, but it's helped me. I suggest take it under Guidance, I am now with an amazing open minded Endo, who knows where I am coming from. Dr Peafield takes care of me using the glandulars and natural


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Thanks a lot, Monica01!


Hi Anna, interesting post.

I too am taking NAX, as advised. Did you have the 24 hr saliva tests done before taking NAX? My results were all too high. My ankle reflex was bad hence the NAX I think. My daughter who has no formal thyroid diagnosis but the same adrenal saliva results as me ( and the beginnings of Hashi's and obviously hypothyroid) is not taking NAX but I think she is worse since starting NDT( without taking any NAX) , terrible anxiety, depression and sleep problems, although no change has been suggested on review. I had to stop my thyroid meds while preparing to take NAX . I have been taking NAX for 4 months now, up to 4 a day in last few weeks. I am now thinking that I should be avoiding the adrenaline and hence that NAX is wrong for me. I'm confused about this supplement and its uses. Any views?


Sorry, that was Monica's post I was responding to , whoops :-)


Hi Sue,

No, I never had a 24 h saliva test, for the simple reason that I did not know where to order one (in Belgium).

I have been diagnosed with adrenal fatigue based on blood tests and 24 h urine analysis. Most of my symptoms also corroborate that diagnosis.

I have been on Medrol for a few years now, but cannot say it has done that much for me...but maybe I would feel even worse if I went off it:-( My doctor said I cannot take HC as I tend to retain fluid, and HC will make that worse. However, I have read that only people who take supra physiological doses of HC (for instance because of arthritis) will have to worry about getting a "moon face". Also, when I was told I had a tendency to retain fluid, I had been on T4 drugs only for ten years, and that could explain why I looked puffy...



Hi Anna, so you are still not sorted? For your information, the saliva test can be ordered through Genova Diagnostics. it comes with all the packaging to keep the samples fresh and I am sure they would be able to advise you whether there is a way to get it from Belgium to UK in good condition. My blood cortisol was also high but my GP wouldn't do any further tests. I also retain fluid but I have found that it is related to what I eat. When I avoid the things that I know set it off, my ankles go skinny. At the moment they are recovering from my eating a pepporoni pizza. I think it is the sodum nitrates they use to preserve meat that my body hates. This includes cured meats like ham, hot dogs and bacon. I have also found that all pork products, joints, chops etc contain it too. Beef steak seems to be OK, don't eat lamb so not sure.

15 years or so ago , before I was aware of any thyroid problems, I did a detox, no wheat, dairy, meat, coffee or alcohol. Despite the fact that I couldn't cut out my morning coffee so still had a little cows milk. 2 weeks in , my ankles went so skinny, I lost a stone in a month ( no calorie counting) and felt fantastic. My husband had similar results too. My ankles had been consistently swollen to some degree or other for 4 years at that point. why the heck didn't I continue eating like that :-(

I mention all this just in case your retention has the same causal link. I have had these issues for 20 years and it is only now I am finding out why. Because I am 'clean', when I do eat something i shouldn't, the response is almost instant and takes several days to clear.

So going back to the adrenal support are you aware of 'Stop the thyroid madness' ? great book, full of information. Bye for now.



Yes, I have the first STTM book, and just ordered the second book.

I sometimes think that it was a bad idea to go on NDT and adrenal support (Medrol) at the same time...many say you should support the adrenals first, and only add NDT when they are stronger. Even if the Hertoghe doctors are better than the average physician, they are not infallible...

That way of eating must be extremely healthy...there are so many things I could give up easily, like meat, wheat, dairy, junk food in general...the only thing I would have a hard time giving up would be a cup of coffee (or two) in the morning, to get me going, and a little red wine a few times a week. But I guess that eating a healthy diet 75% of the time is better than not at all...I doubt very much I could do it 100% of the time. But your results sound extremely impressive...well done!

Thanks for the tip about Genova Diagnostics, I always thought you could only order saliva testing kits from the US! I'll look into it.

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Hi Sue

Yes I had the saliva analysis, the first one I did, 4 years ago, all my levels were very high, I did the second one last year, still high, not as high though.

The last one was in September, all normal. I have been on T3 for a while, I have now reduced my Nutri ad x to 2, and Dr P said i should be able to come off them, soon.

I take a break on Sundays, and don't take anything apart from T3, I am also taking a raw T4, I have just had my bloods taken, too check for T3/T4 levels.

I also take Vit D Metafolin, Iron and krill oil. I am in the middle of my MSc Nutritional therapy dissertation, and my focus is amazing. My concentration is so sharp now, and the weight is coming off, with healthy eating and my brilliant maxi climber.

It can be done, baby steps, but it can be done.


Sorry to interrupt your studies. I am supposed to be working on an OU course at the moment but can't get it together unless I am reaching a deadline. So glad to hear it can get better. You were taking NAX for several years before your saliva tests improved. Did you think at any point about changing to a different source for the adrenal support and what about avoiding adrenaline? That's what started me off on this today, wondering whether I should be avoiding adrenaline, not that you would think for a minute, looking at me, that i had too much adrenaline :-)

I have 4 NAX a day at present and am taking NDT x 4 but am wondering about switching to T3, also for my daughter because she is not responding to NDT'. I am taking D3 5000ug, iron ( just about to switch from spatone to bisglycinate) , vit c high dose, B12 high dose, Coq10 with Omega 3 (thorne research), Ashwaghanda. About to get some Tulsi. I was taking folic acid but I think we ran out or something. Is metafolin the best source?

Sorry to pry but I am desperate to hep my daughter, as well as me, she is about to drop out of her Uni course because of these problems. :-(



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